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Clinical Aspect of High Dosage Vitamin A Supplementation on Neonatus (Aspek Klinis Suplementasi Vitamin A Dosis Tinggi pada Neonatus)
Vitamin A deficiency is a major cause of blindnes, mobidity and mortality among young children throughout the developing world. In Indonesia high dose of vitamin A supplementation has already been done to children after six months old supplementation to neonates was not available yet. The purpose of this study is to evaluate the effects of high dose vitamin A (50.00 IU) supplementation in neonates especially from clinical point of view. Two thousand fifty eight neonates were randomly administered 50.000 IU oral vitamin A (n=1031) or placebo (n=1027). Infants were assessed for bulging fotanelle, head circumference before, 24 hours and 48 hours after dosing. Nine hundreds and seventy two infants were examined by cranial hemorrhage. Groups were comparable at base line. Slight bulging fotanelle occurred among 2.7 percent in control and 4.4 percent in the vitamin A group at 24 hours; moderate bulging fontanelle did not occur in the control group but it was found in 0.1 percent of vitamin A group, and severe bulging fontanelle did not occur in both groups. At 48 hours slight bulging fontanelle occured among 2.4 percent in control and 5 percent in vitamin A group, however, moderate and severe bulging fontanelle did not occur in both groups. No infant developed any signs of intracranial hemorrhage clinically and radiologically as well. Bulging fontanelle was not associated with any signs and symptoms of increase in intracranial pressure. No serious clinical effects were found in the supplementation of high dose vitamin A in neonates. This dosing appeared to be safe for neonates.
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